Momentum Speech Therapy Inc

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

MOMENTUM SPEECH THERAPY INC

Practice address

14369 Park Ave Ste 201a
Victorville, CA 92392-2300

Phone

(760) 278-1484

Fax

(855) 719-2558

NPI assigned

Apr 21, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Semetrah Alima Kincannon, CCC-SLPNPI 1518436278

Title

Speech Language Pathologist

Phone

(760) 278-1484

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Semetrah Alima Kincannon, M.S. CCC SLP

  • Speech-Language Pathologist
  • Victorville, CA
  • NPI 1518436278
  Medicare reassignment NPD Authorized official
• Brandon Clark, SLPA

  • Speech-Language Assistant
  • Victorville, CA
  • NPI 1619851615
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1618963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724889600000",
    "number": "1134701048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12722 SILVER SPUR WAY",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923927437",
            "telephone_number": "760-694-3240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14369 PARK AVE STE 201A",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923922300",
            "telephone_number": "760-278-1484",
            "fax_number": "855-719-2558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOMENTUM SPEECH THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-21",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A",
        "authorized_official_last_name": "KINCANNON",
        "authorized_official_first_name": "SEMETRAH",
        "authorized_official_middle_name": "ALIMA",
        "authorized_official_title_or_position": "SPEECH LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "760-278-1484",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mojave Valley Physical Therapy
• Beverly Encarnacion Mojica, PHARMD.
• Seeun Mok, DMD
• Molina Healthcare of Californa
• Maria Alejandra Molina Rodriguez, MD
• Faraz Momin, MD
• Monchit Corporation
• Patricia Lynn Monkiewicz
• Monica Montalvo
• Jamie Dawn Monteleone

• Speech-Language Pathologist in Victorville, CA
• Providers in Victorville, CA by specialty
• Speech-Language Pathologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.